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Happy Men’s Health Month, guys.

What’s that all about, you ask? June was first established as National Men’s Health Week by Congress in 1994, largely due to the efforts of Senator Bob Dole, and signed into law by President Bill Clinton. That kicked off a week-long focus on gender disparities in health.

The original Senate Joint Resolution pointed out a simple depressing fact: Despite numerous advances in med tech, the ladies outlive dudes by an average of seven years. The Resolution went on to provide a grocery list of the ways guys die, including from prostate cancer, testicular cancer, lung disease, colon cancer, and more -— followed up by the fact that many of these diseases would have had better outcomes if the dudes would’ve just gone to see their doctors earlier.

“Men who are educated about the value that preventive health can play in prolonging their lifespan and their role as a productive family member will be more likely to participate in health screenings,” the Resolution reads.

Depending on how you look at it, however, this awareness month may be pointless for us men living with type 1 diabetes (T1D). That’s because the charter is to increase awareness of preventable health problems and increase men’s interface with the healthcare community.

We men with T1D have a non-preventable autoimmune condition, and God knows we already interface plenty with the healthcare community. Still, this is an opportunity to look at a few ways that T1D affects our overall health as men.

We have that whole Y chromosome thing going on and it’s important to know how diabetes impacts each of the fundamental elements of manhood.

Women are often the ones talking most about fertility as it relates to the effects of T1D, but men also share these concerns.

In a study published in the Journal of Fertilization in 2015, researchers in India took a look at “diabetic male infertility.”

Now we all know that poorly controlled diabetes can lead to reduced fertility thanks to the perfect storm of erectile dysfunction (ED), reduced sex drive, and lower ejaculate volume from damaged ejaculation nerves and diabetes-lowered testosterone levels. With stuff happening on the genetic level, too, this research team wanted to know more about the nuts (pardon the pun) and bolts of that.

The study found that infertile men with either type 1 or type 2 diabetes were literally missing parts of their Y chromosomes! Where the heck did the parts go? Somehow, the diabetes caused “microdeletions” of parts of the Y, and those missing parts in turn triggered “partial or complete spermatogenetic arrest,” or sperm death. Well, more correctly, lack of sperm formation.

In blunt terms, the diabetes emasculated them.

It did this in two ways: First, the biological definition of manhood is a Y chromosome, and the diabetes just hit the erase key on part of it. Second, a key component of manhood for many is being able to spread your genes, which is tricky to do with arrested sperm.

This was a major concern for the authors of the study, too. They noted that given the growth in diabetes and, apparently, growth in global male infertility, “the future of male fertility may be impaired by diabetes mellitus.”

All political correctness aside, we can all acknowledge the fact that a great many men (and a good number of women, as well) measure manhood below the belt, and it’s no newsflash that diabetes affects that area.

Much has been written on the links between diabetes, blood sugar control, and ED, so we’ll keep it brief.

Men with diabetes suffer more ED, and get it at an earlier age. Higher blood sugar most definitely makes it worse — and the higher the blood sugar, the lower your erection — but there appears to also be an inherent risk just from having diabetes, regardless of blood glucose control.

Think back to when you were 12 years old, and possible memories of your mother telling you not to drink coffee because it might stunt your growth. (This, by the way, is sorta true: Caffeine in high doses can increase the body’s elimination of calcium, but we’re not seeing an epidemic of dwarfism with the increase in Starbucks stores…) But what about diabetes? Can diabetes stunt your growth?

Yes, it actually can. Interestingly, while there’s some evidence that kids with T1D are generally taller than their peers before diagnosis, they then suffer a “significant reduction in the pubertal growth spurt.”

In other words, diabetes can stunt your growth both in speed and final height. Now, there’s some evidence that the quality of diabetes control has a part to play, as it does with all types of diabetes complications. Poorer control is linked to reduced “growth velocity.” Additionally, there’s some anecdotal evidence seen for T1D males also being generally lighter of frame than their “sugar-normal” counterparts, with a thinner, leaner build.

What about that fundamental badge of manhood since the cavemen: Our beards and our body hair? Does diabetes affect that?

Yes, it does. Diabetes messes with the usual hair growth cycle, resulting in a greater loss of hair body-wide during the resting cycle, and a reduced and slowed re-growth during the replacement cycle. Research also shows that hair shaft diameter is “significantly reduced” in people with diabetes, and on top of that, meet alopecia areata, an immune system attack on hair follicles more common in those of us who have diabetes.

It’s a wonder we don’t all look like hairless, grey aliens.

For guys who developed T1D before puberty, reduced testosterone levels often lead to reduced body hair and thinner, fairer “peach fuzz” beards in the first place, all of which last into adulthood.

And a German study looked at pubic hair, literally, to evaluate “pubertal onset” in T1D kids. Their findings? Boys (and girls) with diabetes may be late bloomers, but at least reach sexual maturity on time. There was no data about the quality of the pubic hair shaft diameter this phase in life.

Everything we are as men — our Y chromosome, our caveman beards, and the size of our manly parts — are all brought down by our diabetes. So now what?

Keep heart and focus on the second word in “Men’s Health Month,” — namely, “health.”

So we might end up less “manly” than the men of the past — with our damaged chromosome, slightly reduced size, thinner beards and balding heads, and at-risk bedroom capabilities. But we can take the ultimate revenge on diabetes by doing everything in our power to live healthfully.

Male PWDs (people with diabetes) reading this: Go see your doctor regularly. Mind your glucose management, and take care of all the other aspects of your diabetes — and whatever else may ail you.

Get your recommended health screenings regularly. Encourage the other men in your life to do the same, and maybe we can have the last laugh by outliving the ladies.

Despite our manly diabetes.


Wil Dubois lives with type 1 diabetes and is the author of five books on the illness, including “Taming The Tiger” and “Beyond Fingersticks.” He spent many years helping treat patients at a rural medical center in New Mexico. An aviation enthusiast, Wil also works as a private flight instructor. He lives in Las Vegas, N.M., with his wife and son.